MEDICARE: DR. STEPHEN M LEVINE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	00G21183	CA
2	2084P0005X	Neurodevelopmental Disabilities Physician	00G21183	CA
3	208D00000X	General Practice Physician	00G21183	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497846687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN M LEVINE MD

Provider Business Mailing Address
First Line	:	12343 ERWIN ST
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-4613
Country	:	US
Telephone Number	:	760-243-9316
Fax Number	:	818-761-9847

Provider Business Practice Location Address
First Line	:	12343 ERWIN ST
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-4613
Country	:	US
Telephone Number	:	760-243-9316
Fax Number	:	818-761-9847

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	04/22/2008

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